r/FluentInFinance • u/The-Lucky-Investor • 11d ago

“Medicare for All” would save the U.S $5.1 Trillion over 10 years Discussion/ Debate

https://www.commondreams.org/news/2018/11/30/easy-pay-something-costs-less-new-study-shows-medicare-all-would-save-us-51-trillion
21.5k Upvotes

92% Upvoted

2.6k comments sorted by

View all comments

99

u/imposta424 11d ago

How much would we save if overweight adults dropped to below 20%?

74

u/BigPlantsGuy 11d ago

What’s your proposal?

it is crazy how well obesity rates correlate to political parties.

If you start at the fattest state, you have to go to number 13 before you hit your first democratic 2020 voting state. 19 for your second. Only 2 dem states in the bottom 20, only 4 rep states in the top 20

65

u/ncroofer 11d ago

It’s also crazy how it correlates to poverty. Poor people are fat, and poor people vote Republican.

40

u/TyphosTheD 11d ago

Generally speaking, according to Pew Research, poor people tend to be more Democrat leaning.

https://www.pewresearch.org/religious-landscape-study/database/compare/party-affiliation/by/income-distribution/

37

u/muffledvoice 11d ago

The urban poor lean democrat. The rural and small town poor lean heavily republican/conservative. It’s worth noting that the former are often minorities while the latter are mostly white.

15

u/TyphosTheD 11d ago

A useful distinction to be sure.

7

u/Pandaburn 10d ago

Also: poor states vote republican, rich states vote democrat. But within a given state, a richer individual is more likely to vote republican.

0

u/Weekly-Surprise-6509 10d ago

You could also just say "property owners" vote republican

6

u/Dicka24 11d ago

There's a higher rate of poverty amongst minorities. Minorities tend to vote....oh wait.

1

u/Obie-two 11d ago

But it isn’t about “higher rate” it’s about “what if 20% of the total population became not obese”. And the vast majority of them are rural white poor Americans.

6

u/TummyDrums 11d ago

The poverty-fat relation has actually been studied a lot anthropologically. Basically throughout the history of mankind, the least nutritious, fattening foods are the cheapest, while the healthiest are more expensive. Essentially Top Ramen and hotdogs are cheap while fresh vegetables and lean properly fed meats are more expensive. Not that its that simple on a case by case basis, but when you look at the population as a whole the theory is that it has a very large effect.

0

u/chill_brudda 10d ago edited 10d ago

Vegetables are very cheap. Rice, beans, lentils are very cheap. Obviously, you don't buy them very often either. Only buy food with 1 ingredient(potatoes, cheese, green beans, banana etc), and you'll be surprised how much you save. Fast food, heavily processed foods way more expensive and less nutrient dense.

If anything it's a problem of having time to process whole foods snd access. There are food deserts in the US where large swaths of folks do not have grocery stores thst carry fresh produce, it's all Dollar stores etc

It's also about preference. People love fried food, pizza, grain based dessert and sugar drinks. Broccoli and leafy greens not so much

Obesity is not a problem humans have been dealing with "throughout the history of mankind" it's a modern problem. Eating 4000 calories per day while sitting on your ass was not easy "throughout the history of mankind"

2

u/TummyDrums 10d ago

Obviously you don't know the meaning of "fresh" vegetables as I mentioned, if you listed rice, beans, and lentils. Also notice those things are much higher in carbohydrates. Nobody has a big pile of rice and calls it a serving of vegetables; that's a serving of starch.

-1

u/chill_brudda 10d ago edited 10d ago

I mentioned rice and beans in a separate sentence than vegetables, obviously denoting their difference. Bad faith argument there

My overall point was about whole foods which fresh vegetables are a part of, being cheaper and loaded with more nutrients than highkt processed highly palatble foods. Besides you cannot just survive from fresh vegetables alone, we are talking about the real world here.

The fast food industry is a multi billion dollar a year industry. People choose to buy that food over making a healthy life style decision to eat a whole food nutrient dense diet.

Billions of people survive off rice, legumes snd fresh vegetables and are not obese.

Becoming obese requires consuming more calories than you expend on a daily basis for quite a long time. It's basic science.

1

u/Familiar_Gas_1487 11d ago

Hey hey hey

I'm a poor fat liberal

1

u/strait_lines 11d ago

Most of the poor people around here vote democrat

1

u/Brilliant-Mind-9 10d ago

Also correlates with fear and stupidity.

1

u/Alternative-Put-3932 10d ago edited 10d ago

Even polls fox show its almost an even split for Biden and trump for poor rurals.

1

u/tigerscomeatnight 10d ago

Poor people need medicare for all, poor people vote against medicare for all.

1

u/Weekly-Surprise-6509 10d ago

Uh...I think you are a tad bit incorrect on those voting demographics

0

u/LHam1969 11d ago

I thought Republicans were "the party of the rich." You need to make up your mind.

1

u/Glarson1125 11d ago

These things do not contradict each other. Republicans whole thing is fucking over poor people and then telling the poor people they're fucking over that it's the poor people's fault.

1

u/LHam1969 10d ago

Poor people are so lucky to have smart guys like you to look out for them.

0

u/SouthEndCables 11d ago

Poor people live off the dole. They tend be above the average weight. No, don't ask for stats. I've seen it for all of my adult life.

5

u/Ginden 11d ago

What’s your proposal?

Pay 100 billions to Novo Nordisk (something like 20 times their profit from Ozempic) and make patent available for free.

It's probably the best investment possible, as US is estimated to lose $170B every year (2016 prices) due to obesity and overweight.

3

u/BigPlantsGuy 11d ago

So instead of saving $5.1 trillion, we instead save $170 billion (minus 100s of billions we have to pay)?

8

u/Ginden 11d ago

Eh. It's $5.1T over 10 years (claimed by politician), while $170B (in 2024 prices it's $225B) is every year.

So Ozempic nationalization would cost $100B now to save $2.25T over 10 years.

This has key political advantage over universal healthcare - patent nationalization would be effectively irreversible, while universal healthcare can be gutted by Republicans in next election cycle. It can also be framed in "patriotic" terms, like creating jobs in American pharmaceutical factories.

0

u/BigPlantsGuy 11d ago

So we would save half as much as we would if we ignored your suggestion and just did M4A?

3

u/magikarp2122 11d ago

Don’t have to worry about Republicans gutting it is a huge advantage.

1

u/mrpenchant 10d ago

You're ignorant of medical patent practices if you think one patent no longer being valid suddenly means the drug is definitely going to be affordable to access.

Pharma companies would take the $100 billion and then still work out how to massively profit off the drug regardless.

Systemic change has actually shown itself to be stronger because while Republicans have vowed to repeal the ACA since it passed, 14 years later it is still here.

I'll also note this idea that a drug no longer has a patent and everyone being free of the ailments that drug is meant to solve are 2 very different things. Cost isn't inherently solved, people aren't necessarily convinced, and administering it would be a significant process.

-1

u/BigPlantsGuy 11d ago

They could just sell the patents to a private company. There are very few ways to “republican proof” our country

2

u/SippieCup 11d ago

Novo will make over a trillion over the next 30 years from Ozempic and the future generation of the drugs.

1

u/Ginden 11d ago

Semaglutide patent expires in 2026 in Europe and 2033 in US. It currently makes only $14B per year in sales.

Buying patent does not prevent them from making future generations of drugs. It doesn't prevent them from making Ozempic, just other companies (there are thousands of drug manufacturers in US) can make it too.

2

u/SippieCup 11d ago edited 11d ago

There was a recent interview with the ceo of eli lily last Sunday on the daily podcast by the NYT. He talked about how with semaglutides they “arent going to make the same mistake they made with Prozac” where they just sat on Prozac making bank until it expired.

They have plans for the new few decades of the next generation of Semaglutide drugs that will be even more effective and branch into many different fields all with new patients. Stuff like Alzheimer’s, addiction, etc for dozens of different kinds of treatments.

Eli currently has two facilities producing these drugs and by 2030 want to have over 15. They will be mining this goldmine for a long time, and each new drug will be more effective than the previous.

The $15B in sales is far more severely supply limited than nvidia gpus. They can see it being in the hundreds of billions by 2030 for Eli alone. Eli has raised its revenue projects because of semaglutides alone to $42 billion in 2024.

They haven’t even reached the tipping point of revenue which is when they have it in pill form instead of injectables which will greatly increase production.

Edit: kinda lost the plot there… my point is that there is no reason for novo or Eli to sell any patents as they will easily exceed 100b by the time the patents expire on the original drug to open it up for competitors.

Kinda sucks, but yeah. They think these drugs alone will bring them to nvidia levels of market cap.

2

u/econpol 10d ago

Also, sugar tax would be good. Make soda a luxury.

1

u/Old_Height_8351 10d ago

There may be a short term effect of losing weight using drugs, but they won’t be on this med forever and likely revert back to their old weight because the root cause hasn’t been solved. Poor lifestyle habits, poor diet choices, and sleeping habits

1

u/Ginden 10d ago

So what?

1

u/Old_Height_8351 10d ago

So this thread is about spending on healthcare. If you’re not actually fixing the reason someone is obese, this wouldn’t be a long term fix leading to a potential short term reduction in spending but not a significant reduction long term

1

u/Ginden 10d ago

Yes, semaglutide is life-long treatment. It can be produced and sold at profit at prices somewhere around $120 for year therapy. Assuming $225B (2024 prices) yearly cost of obesity and overweight in US, and 60% of population obese/overweight, it's 1130-120 ≈ 1000 dollars saved per obese person.

And remember, $225B is underestimate, as it counts only healthcare costs, without factoring in lost productivity, disability payments, fertility loss, quality of life loss.

1

u/Old_Height_8351 10d ago

It’s a lifelong treatment if people are adherent to it and have the money to pay for it.

My point still stands about solving for root cause. If you don’t change your habits, you’ll still have poor health outcomes regardless of being obese or not. Not being obese is certainly preferred but you also need to be healthy. There are skinny people that are metabolically unhealthy

1

u/Old_Height_8351 10d ago

One thing we should take into consideration here is how immensely hard it would be to change from our current model to a Medicare for all model. The entire system is built a certain way and, whether you like it or not, a lot of people have made their living in this system. If you take that away you’re taking away jobs. That could be hard.

Likely, a change like this would take decades if we wanted to do it well, and we’d still have a private system for the wealthy just like in other countries with social medicine. So you could inadvertently be creating a system that’s worse for poor people.

And this would be a massive upfront cost to implement. Long term that could still workout favorably but we do have a quite the debt crisis in this country at the moment.

Just some thoughts. I don’t like what large insurance companies are doing either

2

u/redditusersmostlysuc 11d ago

WTF is the point of your answer around political parties. His question is what if they dropped weight, not who they voted for.

BTW, the older a person gets, the more conservative (Republican) and fatter they get. So...

2

u/unclejoe1917 11d ago

I believe the point is that republicans like to deflect the cause of our exorbitant healthcare costs away from the best way to pay for healthcare to stuff like, "well, if we weren't such a fat country, we wouldn't be spending so much on healthcare." It absolves the private insurance model because, god forbid we get " ThE sOcIaLiSm"

-1

u/BigPlantsGuy 11d ago

I was just looking at obesity rates and noticed that all the fattest states are republicans and all the least fat states are democratic.

Political party correlated much better with the obesity rate than obesity rate does with avg age in the state

1

u/Jesse1472 11d ago

You seem to heavily suggest weight is tied to political party. At least that’s what any sane person would determine when reading a “it’s crazy” statement. Then you go on to offer nothing of economic savings in response to the person asking about the saving of lowering obesity. Your comment was way out in left field looking for a way to spin it into politics.

1

u/BigPlantsGuy 11d ago

I don’t see how a sane person can think medicare 4 all is not political.

Obesity rates by state is strongly correlated to political party in power. I am not suggesting that. I am saying it directly

1

u/Jesse1472 11d ago

See now that comment has some substance to it. You actually contributed to the discussion beyond just some cryptic response. You didn’t address the point in the original comment asking about economic savings still, but at least in this response I could tell you are saying “access to medical care for everyone has a greater impact than cutting obesity”.

1

u/BigPlantsGuy 11d ago

If you want a stance: we would save tens of trillions in healthcare if republicans were not in power anywhere.

1

u/samg422336 11d ago

Where do you find this type of demographic voter data?

1

u/BigPlantsGuy 11d ago

Google “obesity rate by state”

1

u/drewskibfd 11d ago

Gotta keep 'em fat, stupid, and gullible.

1

u/LivesInALemon 11d ago

My proposal is to deal with the systemic root cause, the grubby hands of rich corpos... again.

This time the food industry though, so yay at least we have many different kinds of cartoon villains.

1

u/SleepyHobo 11d ago

There’s always someone frothing at the mouth to bring politics into any subject.

1

u/BigPlantsGuy 11d ago

Just pointing out an interest relation. Health is political unfortunately.

Medicare 4 All is obviously political so it’s not like this was a non political discussion

1

u/therealCatnuts 11d ago

Ozempic for all. Srs. 

1

u/SodamessNCO 10d ago

A lot of poor people are also black. Most of the poorest states that are also red, have the majority it America's black population in them. A lot of the things people criticize red (particularly southern) states for are shared and expressed more strongly in the high black populations in those states.

0

u/BigPlantsGuy 10d ago

Political party has a stronger correlation to the obesity rate by state than “% of black people” does. The fattest state: West Virginia, is only 3% black.

It’s the politics unfortunately. But excellent attempt to blame black people for republican’s problems. Are you a republican elected official?

1

u/SodamessNCO 10d ago

It's actually well known that we suffer from higher than average rates of obesity and other health issues. We also suffer from higher rates of poverty as well. I would know, my dad's side of the family was brought to Louisiana as slaves and my sister and I are the first generation raised outside the south. They're all horribly afflicted with obesity and diabetes. My aunt just lost her legs to it, and my cousin has congestive heart failure. My other grandparents were raised in New Jersey and those family members are a little more healthy in general.

1

u/BigPlantsGuy 10d ago

Political party has a stronger correlation to the obesity rate by state than “% of black people” does. The fattest state: West Virginia, is only 3% black.

It’s the politics unfortunately. But excellent attempt to blame black people for republican’s problems. Are you a republican elected official?

1

u/Nodan_Turtle 10d ago

Tax the every living christ out of unhealthy foods and sugary drinks. That'd be a good start.

1

u/BigPlantsGuy 10d ago

That’d require democrats to be in control. Or republicans to wake up one day and care about health

1

u/Old_Height_8351 10d ago

What does political affiliation have to do with this point? Unhealthy is the norm across the political spectrum

1

u/BigPlantsGuy 10d ago

Health is inherently political in this country unfortunately.

1

u/Old_Height_8351 10d ago

Could you please expand on that?

1

u/BigPlantsGuy 10d ago edited 10d ago

Health is inherently political. Why do americans have worse health than our peers? Politics.

Same reason half the country prefers wasting trillions on inaccessible, subpar private healthcare instead of universal healthcare: politics.

Why is our food less healthy than our peers? Politics

Why are our cities less walkable leading to car dependence? Politics

Why do millions more americans have access to healthcare than before obama? Politics.

Why were millions almost stripped of health insurance during the pandemic? Politics?

Why did red states refuse medicaid expansion, refuse money for healthy school lunches, and explicitly ban various forms of healthcare? Politics

1

u/Old_Height_8351 10d ago

US healthcare certainly isn’t subpar. Likely the best in the world when the outcome variables are controlled for acuity. Yes it is very expensive though.

I agree on the food part mostly. It is still your choice to eat unhealthy foods at the end of the day.

Our healthcare is very accessible. You can get appointments in a matter of days or a few weeks for the vast majority of services, or you can go to urgent care or an emergency department and get care in minutes/hours.

I don’t think politics has anything to do with how walkable our cities are. Americans like having large houses and yards so they want to live in a suburbs. People that live in big cities can walk to the places they need for the most part.

Nobody was stripped of their health insurance so I don’t understand your point there. Even if people don’t have insurance, under EMTALA you can’t be refused to emergency care. This is how migrants use the healthcare system essentially. They are told to show up at an ED for their care because they can’t be refused. This is obviously a bad system for care but you still have the option

1

u/BigPlantsGuy 10d ago edited 10d ago

US healthcare is so far from best in the world. We pay more for worse outcomes. Sure if you are a millionaires you can get good healthcare. That’s true everywhere.

To my knowledge, the US is the only wealthy country in the world where people ration insulin or go into debt for healthcare.

The only rich country where people diagnosed with diseases opt to not get treated because they cannot afford it

1

u/Old_Height_8351 10d ago

The “worse outcomes” is a typical talking point I see that doesn’t have much rigor if you dissect it.

If you travel to most other countries, you don’t see as many obese, wheelchair-bound people. Most countries are healthier and that’s why they don’t spend as much healthcare and that’s why their outcomes look better. Americans don’t take care of themselves well, so we have so much cancer and heart disease. Our healthcare system is of much higher quality than almost every country, just go to a hospital or physician abroad and you’ll see that immediately

1

u/BigPlantsGuy 10d ago

Much rigor? What data do you need to see?

Life expectancy? Maternal mortality rate? Disease prevention? Affordability? Obesity rate? Heart disease? Diabetes? STDs? Aids? Addictions?

All bad

→ More replies (0)

1

u/GeekShallInherit 10d ago

The “worse outcomes” is a typical talking point I see that doesn’t have much rigor if you dissect it.

Except US outcomes are terrible, and behind all its peers.

https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003013#sec018

And medically avoidable deaths are higher as well.

https://www.commonwealthfund.org/publications/fund-reports/2017/jul/mirror-mirror-2017-international-comparison-reflects-flaws-and?redirect_source=/publications/fund-reports/2017/jul/mirror-mirror-international-comparisons-2017

you don’t see as many obese, wheelchair-bound people.

Many US peers aren't far behind on obesity. Of the other two top health risks, smoking and alcohol, the US is average or better than average vs. its peers. At any rate the outcomes I've cited above are already adjusted for various demographic and health risks, and we can spot check to see if there's any remaining correlation between obesity and the outcomes. There is not.

https://i.imgur.com/ZOkB9ps.png

Most countries are healthier and that’s why they don’t spend as much healthcare

No, it isn't.

Our healthcare system is of much higher quality than almost every country

Citation needed.

US Healthcare ranked 29th on health outcomes by Lancet HAQ Index

11th (of 11) by Commonwealth Fund

59th by the Prosperity Index

30th by CEOWorld

37th by the World Health Organization

The US has the worst rate of death by medically preventable causes among peer countries. A 31% higher disease adjusted life years average. Higher rates of medical and lab errors. A lower rate of being able to make a same or next day appointment with their doctor than average.

https://www.healthsystemtracker.org/chart-collection/quality-u-s-healthcare-system-compare-countries/#item-percent-used-emergency-department-for-condition-that-could-have-been-treated-by-a-regular-doctor-2016

52nd in the world in doctors per capita.

https://www.nationmaster.com/country-info/stats/Health/Physicians/Per-1,000-people

Higher infant mortality levels. Yes, even when you adjust for differences in methodology.

https://www.healthsystemtracker.org/chart-collection/infant-mortality-u-s-compare-countries/

Fewer acute care beds. A lower number of psychiatrists. Etc.

https://www.healthsystemtracker.org/chart-collection/u-s-health-care-resources-compare-countries/#item-availability-medical-technology-not-always-equate-higher-utilization

Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries

These findings imply that even if all US citizens experienced the same health outcomes enjoyed by privileged White US citizens, US health indicators would still lag behind those in many other countries.

When asked about their healthcare system as a whole the US system ranked dead last of 11 countries, with only 19.5% of people saying the system works relatively well and only needs minor changes. The average in the other countries is 46.9% saying the same. Canada ranked 9th with 34.5% saying the system works relatively well. The UK ranks fifth, with 44.5%. Australia ranked 6th at 44.4%. The best was Germany at 59.8%.

On rating the overall quality of care in the US, Americans again ranked dead last, with only 25.6% ranking it excellent or very good. The average was 50.8%. Canada ranked 9th with 45.1%. The UK ranked 2nd, at 63.4%. Australia was 3rd at 59.4%. The best was Switzerland at 65.5%.

https://www.cihi.ca/en/commonwealth-fund-survey-2016

The US has 43 hospitals in the top 200 globally; one for every 7,633,477 people in the US. That's good enough for a ranking of 20th on the list of top 200 hospitals per capita, and significantly lower than the average of one for every 3,830,114 for other countries in the top 25 on spending with populations above 5 million. The best is Switzerland at one for every 1.2 million people. In fact the US only beats one country on this list; the UK at one for every 9.5 million people.

If you want to do the full list of 2,000 instead it's 334, or one for every 982,753 people; good enough for 21st. Again far below the average in peer countries of 527,236. The best is Austria, at one for every 306,106 people.

https://www.newsweek.com/best-hospitals-2021

OECD Countries Health Care Spending and Rankings

Country Govt. / Mandatory (PPP) Voluntary (PPP) Total (PPP) % GDP Lancet HAQ Ranking WHO Ranking Prosperity Ranking CEO World Ranking Commonwealth Fund Ranking
1. United States $7,274 $3,798 $11,072 16.90% 29 37 59 30 11
2. Switzerland $4,988 $2,744 $7,732 12.20% 7 20 3 18 2
3. Norway $5,673 $974 $6,647 10.20% 2 11 5 15 7
4. Germany $5,648 $998 $6,646 11.20% 18 25 12 17 5
5. Austria $4,402 $1,449 $5,851 10.30% 13 9 10 4
6. Sweden $4,928 $854 $5,782 11.00% 8 23 15 28 3
7. Netherlands $4,767 $998 $5,765 9.90% 3 17 8 11 5
8. Denmark $4,663 $905 $5,568 10.50% 17 34 8 5
9. Luxembourg $4,697 $861 $5,558 5.40% 4 16 19
10. Belgium $4,125 $1,303 $5,428 10.40% 15 21 24 9
11. Canada $3,815 $1,603 $5,418 10.70% 14 30 25 23 10
12. France $4,501 $875 $5,376 11.20% 20 1 16 8 9
13. Ireland $3,919 $1,357 $5,276 7.10% 11 19 20 80
14. Australia $3,919 $1,268 $5,187 9.30% 5 32 18 10 4
15. Japan $4,064 $759 $4,823 10.90% 12 10 2 3
16. Iceland $3,988 $823 $4,811 8.30% 1 15 7 41
17. United Kingdom $3,620 $1,033 $4,653 9.80% 23 18 23 13 1
18. Finland $3,536 $1,042 $4,578 9.10% 6 31 26 12
19. Malta $2,789 $1,540 $4,329 9.30% 27 5 14
OECD Average $4,224 8.80%
20. New Zealand $3,343 $861 $4,204 9.30% 16 41 22 16 7
21. Italy $2,706 $943 $3,649 8.80% 9 2 17 37
22. Spain $2,560 $1,056 $3,616 8.90% 19 7 13 7
23. Czech Republic $2,854 $572 $3,426 7.50% 28 48 28 14
24. South Korea $2,057 $1,327 $3,384 8.10% 25 58 4 2
25. Portugal $2,069 $1,310 $3,379 9.10% 32 29 30 22
26. Slovenia $2,314 $910 $3,224 7.90% 21 38 24 47
27. Israel $1,898 $1,034 $2,932 7.50% 35 28 11 21
→ More replies (0)

1

u/BigPlantsGuy 10d ago

If you were even a little bit aware of local politics and infrastructure/transit/zoning rules, you would never say that you do not think lack of walkable cities in political.

Who decides if a road is widened or a bike lane is added instead? Or public transit is build instead?

Who decides if every corner has shops and neighborhoods have mixed zoning or if it is just miles of single family homes with the nearest store being a 10 minute drive?

Who decided to rip up public transit networks and tear down homes to build highways through cities?

Who decides on parking minimums for new apartments?

Who decides if sidewalks get built?

All of it is politics and most of that is local politics.

Who decides on

1

u/Old_Height_8351 10d ago

You have a point there. If local politics are done right, not saying that’s always the case, those are things residents want. Not everyone wants to live in a walkable place. If you look at how fat people are in general in the US, it’s clear they don’t like walking lol.

1

u/BigPlantsGuy 10d ago

That’s a chicken-egg situation. Most places in the Us are not walkable so people don’t walk.

Walkable cities is a political choice.

→ More replies (0)

1

u/1minatur 10d ago

Only 2 dem states in the bottom 20

3, but your point still stands. Delaware, Wisconsin, Georgia

0

u/tallperson117 11d ago

This is so true. I moved from a very blue area to a very red area a few years back. It took about a week for me to notice that ~80% of people here are overweight, with ~40% of people being morbidly obese. Where I lived previously, maybe 15% of people were overweight, with morbidly obese people being akin to shiny Pokemon.

2

u/Main_Chocolate_1396 11d ago

Did you happen to move from a city to a rural area? City dwellers tend to walk more places than rural folks. Even walking a mile a day makes a huge difference over years.

0

u/RTheMarinersGoodYet 11d ago

Cool, now do cities...

1

u/BigPlantsGuy 11d ago

Is the data broken down that way? I would assume rural areas are considerably more obese than cities but that’s just based on my experience in both.

20

u/GeekShallInherit 11d ago

Not much.

The UK recently did a study and they found that from the three biggest healthcare risks; obesity, smoking, and alcohol, they realize a net savings of £22.8 billion (£342/$474 per person) per year. This is due primarily to people with health risks not living as long (healthcare for the elderly is exceptionally expensive), as well as reduced spending on pensions, income from sin taxes, etc..

In the US there are 106.4 million people that are overweight, at an additional lifetime healthcare cost of $3,770 per person average. 98.2 million obese at an average additional lifetime cost of $17,795. 25.2 million morbidly obese, at an average additional lifetime cost of $22,619. With average lifetime healthcare costs of $879,125, obesity accounts for 0.99% of our total healthcare costs.

https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity

https://onlinelibrary.wiley.com/doi/epdf/10.1038/oby.2008.290

We're spending 165% more than the OECD average on healthcare--that works out to over half a million dollars per person more over a lifetime of care--and you're worried about 0.99%?

Here's another study, that actually found that lifetime healthcare for the obese are lower than for the healthy.

Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures...In this study we have shown that, although obese people induce high medical costs during their lives, their lifetime health-care costs are lower than those of healthy-living people but higher than those of smokers. Obesity increases the risk of diseases such as diabetes and coronary heart disease, thereby increasing health-care utilization but decreasing life expectancy. Successful prevention of obesity, in turn, increases life expectancy. Unfortunately, these life-years gained are not lived in full health and come at a price: people suffer from other diseases, which increases health-care costs. Obesity prevention, just like smoking prevention, will not stem the tide of increasing health-care expenditures.

https://www.rug.nl/research/portal/files/46007081/Lifetime_Medical_Costs_of_Obesity.PDF

For further confirmation we can look to the fact that healthcare utilization rates in the US are similar to its peers.

https://www.oregonlegislature.gov/salinas/HealthCareDocuments/4.%20Health%20Care%20Spending%20in%20the%20United%20States%20and%20Other%20High-Income%20Countries%20JAMA%202018.pdf

One final way we can look at it is to see if there is correlation between obesity rates and increased spending levels between various countries. There isn't.

https://i.imgur.com/d31bOFf.png

We aren't using significantly more healthcare--due to obesity or anything else--we're just paying dramatically more for the care we do receive.

7

u/tiger32kw 11d ago

The obesity epidemic in the US is a HUGE health crisis that needs to be solved, but it’s not the core problem of our healthcare costs. It’s really a greed problem like many other things in the US.

Diabetes care is very costly, but as you outlined obese people with diabetes don’t live as long so cost per lifetime is lower. So I guess since they die sooner it’s a wash.

2

u/Main_Chocolate_1396 11d ago

Phewww. Glad I don’t smoke.

1

u/countdonn 11d ago

I did hear about this recently which goes against the common wisdom on the subject but the numbers do seem to back up that it can actually be cheaper if people die younger which things like obesity will cause.

1

u/GeekShallInherit 11d ago

Which of course doesn't mean that helping people to be healthier isn't a valuable goal for society, but it doesn't tend to cost more money.

0

u/redditusersmostlysuc 11d ago

Your links are all over the place. Being overweight puts people at greater risk for a lot of things. It says so right in the second like you post.

This study quantifies age-specific and lifetime costs for overweight (BMI: 25–29.9), obese I (BMI: 30–34.9), and obese II/III (BMI: >35) adults separately by race/gender strata. We use these results to demonstrate why private sector firms are likely to underinvest in obesity prevention efforts. Not only does the existence of Medicare reduce the economic burden that obesity imposes on private payers, but, from the perspective of a 20-year-old obese adult, the short-term costs of obesity are small. This suggests that legislation that subsidizes wellness programs and/or mandates coverage for obesity treatments might make all firms better off. Ironically, Medicare has a greater incentive to prevent obesity because when an obese 65 year old enters the program, his/her costs are immediate and higher than costs for normal weight individuals.

5

u/GeekShallInherit 11d ago

Your links are all over the place.

They are all relevant.

Being overweight puts people at greater risk for a lot of things.

No kidding. You are intentionally oblivious to the point, aren't you?

3

u/bellj1210 11d ago

you do have a current dollar value arguement here (better to pay 1 dollar per year for 10 years than 10 dollars now with inflation and ability to invest those other 9 dollars over the years).... but the point is that the obese person may cost more now, but they are likely dead by 70 only costing more for 5 years vs. the healthy person who lives another 20- and elderly end of life care is incredibly expensive for those who live into their 80ies and 90ies.

So you are not comparing 5 years of obese to 5 years of healthy, you are weighing 5 years of obese vs. 20 years of healthy weight- and that much longer time is 15 more years for other things to go wrong and cost a lot of money.

-3

u/Fluffy-Gur4600 11d ago

You sound fat.

7

u/GeekShallInherit 11d ago

You sound like an intentionally ignorant fathead, who relishes being the kind of stupid that makes the world a worse place. Best of luck some day not being a waste of everybody's time and a pox on humanity.

7

u/Ginden 11d ago

How much would we save if overweight adults dropped to below 20%?

Around 170 billions per year in 2016 prices, or $1.7T in 10 years.

Fear not, semaglutide is going off patent in 2033 in US and 2026 in Europe.

3

u/Responsible-Fox-9082 10d ago

Hate to ruin your hope, but it's not ever going to legitimately be off patent in the US. They will slightly alter the chemical makeup of it and renew the patent with marginally worse results(more side effects) and keep it going for another 40 years.

Why? Because the people everyone says will help wrote the laws around medical patents to allow this level of bullshit. No not one party or the other. Both agreed to this. They even wrote the way "generic" medicines were to be made in a way that one company can make a life saving drug, make a second company to make the generic and charge 10% less and if anyone questions it rinse and repeat the middle step until no one notices for a life saving medication the only companies allowed to make it all run at a cost you can google the price to manufacture and realize they are all charging way more than necessary if they truly were competing.

They aren't. US healthcare is rigged to dump the entire cost of developing medicine for the world on the US citizen. They can't negotiate with other countries because as you said they have their own patents that follow ours somewhat close so it's play by their rules or miss out on that money so they get their profits from the only place they can. Healthcare wouldn't be so expensive if they had fair negotiations around the world, but they automatically lose China and Russia due to China just stealing everything and they'd sell to Russia on the cheap.

1

u/limukala 8d ago

They will slightly alter the chemical makeup of it and renew the patent

Which won't affect the patent on the original formulation.

1

u/Responsible-Fox-9082 8d ago

It does because they list it under the same patent as the "improved" formula aka there's a reason why Bernie Sanders and Nancy Pelosi and Barack Obama all have multiple mansions in multiple states worth tens of millions of dollars while on(mostly) a 150k-174k salary.

You can't be mad at the companies for being able to bribe politicians who wrote the rules of what a bribe is to only be considered a bribe straight cash. Hell it's why even by congressional standards justice Thomas didn't do a thing wrong. It's just the rules they have made for themselves.

1

u/bellj1210 11d ago

and if you gave everyone easy access to weight loss drugs it would solve itself pretty quickly.

1

u/SeasonPositive6771 10d ago

That is extremely unlikely.

Much like Eliquis, one of the most commonly prescribed drugs in the US, they're just going to apply for a patent extension and get it. Or they are going to say that you must change the formulation very slightly and conveniently that will help them stay in patent.

1

u/limukala 8d ago

You can't get a patent extension that would take it beyond 14 years from the date of approval, which for Ozempic was 2017.

1

u/SeasonPositive6771 8d ago

That's what I've heard, but plenty of other drugs have been given extensions, including Eliquis which was originally patented in 2011. It won't be available apixaban in the US until 2028 at the earliest.

4

u/Zestyclose-Egg4270 11d ago

20% What?

1

u/BasilExposition2 11d ago

I am assuming he means body fat.

3

u/Impossible-Flight250 11d ago

He means below 20% of the population. The percentage of overweight adults is around 60% I think.

4

u/finalattack123 11d ago

Do you propose camps?

2

u/imposta424 11d ago

Good idea, Let me call Ben Stiller.

1

u/chi_moto 11d ago

Ozempic for everyone!!

1

u/strait_lines 11d ago

I think we should call them internment camps, you won’t be able to leave until you hit your ideal bmi.

4

u/whorl- 11d ago

Perhaps that would be more feasible for them if they access to medical guidance, medical care/treatment, and access to a dietician.

1

u/imposta424 11d ago

There are a lot of wealthy overweight people as well. This affects all classes of people.

2

u/whorl- 11d ago

Yeah, and it seems like a lot of them are going on ozempic, because they have the means and ability.

That said, there are very many indicators regarding how poverty exacerbates obesity. This is long-studied and the information is readily available.

2

u/Plastic-Giraffe-4021 11d ago

You’re a moron. This is why we can’t have things like Medicare for all, because some dumbass like you needs to be funny and insert yourself into a serious discussion. Fuck you.

-1

u/Ban_Master 11d ago

Don't need any of that to eat less.

3

u/PrimaryInjurious 11d ago

Obese people tend to cost fewer health care dollars because they die earlier. Same with smokers.

2

u/Halunner-0815 11d ago

Hmm, interesting point, but the CDC and several studies counter this overly simplistic view of a complex situation from different angles.

Direct Healthcare Costs Obese individuals often rack up higher healthcare costs due to increased risks of chronic conditions like diabetes, heart disease, and joint problems. The CDC estimates that annual medical costs for people with obesity are $1,429 higher than those of normal weight.

Smokers also face higher healthcare costs due to increased risks of cancer, respiratory diseases, and cardiovascular diseases. The CDC reports that smoking-related illnesses in the United States cost more than $300 billion each year, including nearly $170 billion for direct medical care for adults.

Productivity and Absenteeism Obese individuals and smokers often have higher rates of absenteeism and lower productivity. The CDC estimates that obesity-related absenteeism costs employers up to $6.38 billion annually, while smoking-related productivity losses are about $156 billion per year.

Long-term Economic Impacts Obesity and smoking increase the likelihood of disability, leading to higher costs for disability benefits and long-term care. These costs can be substantial and extend beyond the individual's shortened lifespan.

Higher rates of chronic diseases among obese individuals and smokers lead to higher insurance premiums for everyone, as the risk pool becomes more expensive to cover. Additionally, public health programs like Medicare and Medicaid bear a significant portion of these costs, impacting taxpayers.

Suggesting that early death due to obesity or smoking is economically beneficial raises significant ethical concerns. It devalues the importance of preventive healthcare and quality of life and can be seen as endorsing harmful behaviours.

2

u/ziggy145 11d ago

Tons!

A great way to do that would be to subsidize healthier foods to ensure people don’t flock to cheaper higher calorie nutrition, and of course universal healthcare lends to reducing waistline inflation via the very mechanism most are concerned about when it comes to socialized benefits: Moral Hazard - when someone has benefits, they will use them (and will be a hurdle, if not THE hurdle, in transitioning to Universal Healthcare, as many have deferred their bodily maintenance due to the cost of such).

If they go to the doctor regularly because they can now do so without the burden of spending their already scarce liquidity, that’s another opportunity to be reminded to reduce weight. 

I’m sure you won’t read this because it’s much easier to just “what about” online all day, but there’s a path to encouraging healthy weight and obesity reduction in America through socialized healthcare. On top of that, since every healthy American is paying into the “insurance pool” (and essentially subsidizing unhealthy Americans, which you should know is how private insurance works as well), it will reduce costs across the board for all of us as we don’t have to work with a smaller liquidity pool to subsidize those who actually use their benefits. 

2

u/casicua 11d ago

The sad thing is that the thing preventing Medicare for All from being a reality is basically also responsible for our morbid obesity problem here: corporate profit.

There is so much artificial sugar added to our everyday foods because it’s addictive and keeps consumers coming back. The obesity, heart disease and diabetes epidemic continues to feed our broken healthcare system and they also profit.

It sounds conspiratorial, but it really is just the byproduct of the fact that our society values corporate profit above all and we’ve been indoctrinated into believing that anything that even remotely inhibits unchecked profit is sacrilege.

2

u/enjoy-me- 11d ago

Ozempic for all!

2

u/Shiro_no_Orpheus 10d ago

Which policies would you suggest to reach this goal?

2

u/CatalystOfUncreation 10d ago

make high fructose corn syrup and artificial sweeteners illegal

2

u/Old_Height_8351 10d ago

People like to blame the healthcare system for its inefficiency and cost, yet don’t think about the point you just made. People are unhealthier than ever, need more complex care, and it is immensely complex to add more services and capacity to the system. If you want to help make the healthcare system better, it starts with you. Stop living an unhealthy lifestyle

1

u/fillmorecounty 10d ago

We've been blaming the individual for decades and the problem continues to get worse anyway. Telling people to make better choices when garbage food is cheaper and designed to be addictive isn't going to do much. Maybe there needs to be a different approach.

2

u/Old_Height_8351 10d ago

Better nutrition education for kids and young adults. But even then, it’s up to the individual to make good choices. You’re the one making bad choices

1

u/countdonn 11d ago

There where efforts to add warning labels to unhealthy foods like soda in the US like they do in Mexico but that was crushed of course. Another great way to help would be to tax things like soda to discourage consumption, also unlikely to happen.

1

u/DINABLAR 11d ago

Negative billions of dollars. Obese people don’t live very long and old people take up a shitload of medical care resources. Ozempic is going to actually overload our medical system because people are going to start living longer.

1

u/Revolution4u 11d ago edited 1d ago

[removed]

1

u/MojyaMan 11d ago

So walkable cities?

1

u/SuitableStudy3316 11d ago

We would save some, yes, but with increased life expectancies it wouldn't be as much savings as you think. We've all got to die of something.

1

u/GhostCorps973 11d ago

Gonna be kinda hard to do unless we can get companies to stop using manufactured food additives instead of real ingredients. Lowering food quality, making people fat, and giving them cancer just so stock prices can go up half a percent 🤡

1

u/cybercuzco 10d ago

Well if we had universal healthcare we could use the data from that to create policies that would make people healthier and thus reduce overall expenses.

1

u/Robo_Narples 10d ago

Not that much.

1

u/MRolled12 10d ago

Idk, but I do know that regular visits with someone’s doctor can help them overcome health struggles like obesity. Or are we supposed to pretend like they just need to eat a couple of salads and walk a mile?

1

u/tigerscomeatnight 10d ago

Same principle. Define weight as a medical condition instead of waiting until it is diabetes or heart attack and then we can treat it. Have medicare for all cover obesity drugs. I think that's what the article is saying, preventive medicine is cheaper. Addressing chronic problems and paying for them is cheaper then waiting for the acute response. More here

1

u/Zamaiel 10d ago

Nothing. In fact it'd cost a huge amount. The slimmer people would live longer into the really expensive old age years, and itd be a large net cost.

1

u/KeptinGL6 10d ago

Below 20% of what? Their current weight? I'd say that would be fatal for most of them, which would certainly be one way to solve the obesity problem.

1

u/MainSailFreedom 8d ago

This is something that needs be taught in school. That and financial literacy. Many kids graduate high school without any real understanding of how nutrition and personal finance work.